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adrenal vein sampling

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https://www.readbyqxmd.com/read/29904467/bringing-sasi-back-single-session-selective-arterial-secretin-injection-and-transarterial-embolization-of-intrahepatic-pancreatic-neuroendocrine-metastasis-in-a-men-1-patient
#1
Jawad S Hussain, Ravi N Srinivasa, Anthony Hage, Rudra Pampati, Jeffrey Forris Beecham Chick
SASI (selective arterial secretin injection) is a form of ASVS (arterial stimulation and venous sampling) used to localize pancreatic gastrinomas. This report aims to review the protocol for SASI and demonstrate its utility in localizing functional and nonfunctional gastrinomas. Even if a patient has a pancreatic mass and a laboratory profile fitting a specific endocrine syndrome, these may or may not be associated as has been previously demonstrated with adrenal vein sampling. We present a case where a patient underwent simultaneous SASI and bland embolization of a hepatic metastasis to facilitate partial pancreatectomy for Zollinger-Ellison syndrome...
April 2018: Radiology Case Reports
https://www.readbyqxmd.com/read/29899838/impact-of-aldosterone-producing-cell-clusters-on-diagnostic-discrepancies-in-primary-aldosteronism
#2
Mitsuhiro Kometani, Takashi Yoneda, Daisuke Aono, Shigehiro Karashima, Masashi Demura, Koshiro Nishimoto, Masakazu Yamagishi, Yoshiyu Takeda
Adrenocorticotropic hormone (ACTH) stimulation is recommended in adrenal vein sampling (AVS) for primary aldosteronism (PA) to improve the AVS success rate. However, this method can confound the subtype diagnosis. Gene mutations or pathological characteristics may be related to lateralization by AVS. This study aimed to compare the rate of diagnostic discrepancy by AVS pre- versus post-ACTH stimulation and to investigate the relationship between this discrepancy and findings from immunohistochemical and genetic analyses of PA...
May 25, 2018: Oncotarget
https://www.readbyqxmd.com/read/29884668/systolic-heart-failure-in-a-patient-with-primary-aldosteronism
#3
Chikezie Alvarez, Vinuta Mohan
A 53-year-old African man with a 25-year history of uncontrolled hypertension and systolic heart failure presented with an acute congestive heart failure exacerbation. He was found to have severe hypokalaemia, so additional testing was performed, and primary aldosteronism was confirmed. CT scan showed a 1.2×2.4 cm well-defined, homogeneous adenoma of the left adrenal gland. Adrenal vein sampling confirmed unilateral primary aldosteronism with lateralisation to the left adrenal gland. The patient was started on spironolactone and was referred to surgery for laparoscopic left adrenalectomy...
June 8, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29873811/saline-suppression-test-parameters-may-predict-bilateral-subtypes-of-primary-aldosteronism
#4
Hikaru Hashimura, Jimmy Shen, Peter J Fuller, Nicholas Y N Chee, James C G Doery, Winston Chong, Kay Weng Choy, Stella May Gwini, Jun Yang
BACKGROUND: The saline suppression test (SST) serves to confirm the diagnosis of primary aldosteronism (PA) while adrenal vein sampling (AVS) is used to determine whether the aldosterone hypersecretion is unilateral or bilateral. An accurate prediction of bilateral PA based on SST results could reduce the need for AVS. AIM: We sought to identify SST parameters that reliably predict bilateral PA. METHODS: The results from 121 patients undergoing SSTs at Monash Health from January 2010 to January 2018 including screening blood tests, imaging, AVS and histopathology results were evaluated...
June 6, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29766680/c-arm-computed-tomography-assisted-adrenal-venous-sampling-improved-right-adrenal-vein-cannulation-and-sampling-quality-in-primary-aldosteronism
#5
Chung Hyun Park, Namki Hong, Kichang Han, Sang Wook Kang, Cho Rok Lee, Sungha Park, Yumie Rhee
BACKGROUND: Adrenal venous sampling (AVS) is a gold standard for subtype classification of primary aldosteronism (PA). However, this procedure has a high failure rate because of the anatomical difficulties in accessing the right adrenal vein. We investigated whether C-arm computed tomography-assisted AVS (C-AVS) could improve the success rate of adrenal sampling. METHODS: A total of 156 patients, diagnosed with PA who underwent AVS from May 2004 through April 2017, were included...
May 4, 2018: Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29741297/a-pedunculated-aldosterone-producing-adenoma-drained-by-an-extra-vein-causing-puzzling-results-of-adrenal-vein-sampling
#6
Marieke S Velema, Tanja Dekkers, Ad R M M Hermus, Henri J L M Timmers, Johan Langenhuijsen, Mark Arntz, Benno Kusters, Graeme Eisenhofer, Jacques W M Lenders, Jaap Deinum
Primary aldosteronism (PA) is a common cause of endocrine hypertension in which two main subtypes are distinguished: bilateral adrenal hyperplasia (BAH) and aldosterone-producing adenomas (APA).1 Computed tomography (CT) and adrenal vein sampling (AVS) are used to differentiate between these subtypes. There are two basic conditions for AVS. First, aldosterone concentrations should be corrected for peripheral blood admixture by normalizing for cortisol concentration. Second, it is assumed that either adrenal is drained by one vein...
May 9, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29687091/the-occurrence-of-apparent-bilateral-aldosterone-suppression-in-adrenal-vein-sampling-for-primary-aldosteronism
#7
Yui Shibayama, Norio Wada, Mitsuhide Naruse, Isao Kurihara, Hiroshi Ito, Takashi Yoneda, Yoshiyu Takeda, Hironobu Umakoshi, Mika Tsuiki, Takamasa Ichijo, Hisashi Fukuda, Takuyuki Katabami, Takanobu Yoshimoto, Yoshihiro Ogawa, Junji Kawashima, Yuichi Ohno, Masakatsu Sone, Megumi Fujita, Katsutoshi Takahashi, Hirotaka Shibata, Kohei Kamemura, Yuichi Fujii, Koichi Yamamoto, Tomoko Suzuki
Context: In adrenal venous sampling (AVS) for patients with primary aldosteronism (PA), apparent bilateral aldosterone suppression (ABAS), defined as lower aldosterone/cortisol ratios in the bilateral adrenal veins than that in the inferior vena cava, is occasionally experienced. ABAS is uninterpretable with respect to lateralization of excess aldosterone production. We previously reported that ABAS was not a rare phenomenon and was significantly reduced after adrenocorticotropic hormone (ACTH) administration...
May 1, 2018: Journal of the Endocrine Society
https://www.readbyqxmd.com/read/29685132/acth-independent-cushing-s-syndrome-with-bilateral-cortisol-secreting-adrenal-adenomas-a-case-report-and-review-of-literatures
#8
Jia Wei, Sheyu Li, Qilin Liu, Yuchun Zhu, Nianwei Wu, Ying Tang, Qianrui Li, Kaiyun Ren, Qianying Zhang, Yerong Yu, Zhenmei An, Jing Chen, Jianwei Li
BACKGROUND: Adrenocorticotropic hormone (ACTH)-independent Cushing's syndrome (CS) with bilateral cortisol-secreting adenomas has been rarely reported in the literatures. Precise recognition and management of this disorder constitute a challenge to clinicians due to the difficulty of exact location of the functional lesions. CASE PRESENTATION: We herein report a new case of a Chinese female patient with a complaint of exertional dyspnea for over 10 years. ACTH-independent CS was diagnosed based on undetectable ACTH and unsuppressed cortisol levels by dexamethasone...
April 23, 2018: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/29677048/criteria-for-diagnosing-primary-aldosteronism-on-the-basis-of-liquid-chromatography-tandem-mass-spectrometry-determinations-of-plasma-aldosterone-concentration
#9
Stephanie Baron, Laurence Amar, Anne-Laure Faucon, Anne Blanchard, Laurence Baffalie, Catherine Faucard, Simon Travers, Jean-Yves Pagny, Michel Azizi, Pascal Houillier
BACKGROUND: Primary aldosteronism is affecting about 10% of hypertensive patients. Primary aldosteronism should be diagnosed by screening tests based on plasma aldosterone concentration (PAC) and aldosterone-to-renin ratio (ARR), followed by confirmatory test. The cutoff values for PAC and ARR depend on PAC and plasma renin measurement methods. Liquid chromatography-tandem mass spectrometry (LC-MS/MS), the new gold standard method for aldosterone determination, is now widespread but shows lower values than immunoassays...
July 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29616399/techniques-of-adrenal-venous-sampling-in-patients-with-inferior-vena-cava-or-renal-vein-anomalies
#10
Kenji Endo, Satoru Morita, Shingo Suzaki, Hiroshi Yamazaki, Yu Nishina, Shuji Sakai
PURPOSE: To review the techniques and technical success rate of adrenal venous sampling (AVS) in patients with inferior vena cava (IVC) or renal vein anomalies. MATERIALS AND METHODS: The techniques and success rate of AVS in 15 patients with anomalies [8 with double IVC (dIVC), 3 with left IVC (ltIVC), 2 with retroaortic left renal vein (LRV), and 2 with circumaortic LRV] underwent AVS was retrospectively reviewed. RESULTS: Among 11 patients with IVC anomalies, the success rates for sampling the right and left adrenal veins (RAV and LAV) were 81...
June 2018: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/29541836/image-fusion-guidance-with-pre-procedural-ct-with-real-time-fluoroscopy-for-adrenal-venous-sampling
#11
Satoru Morita, Hiroshi Yamazaki, Kenji Endo, Shingo Suzaki, Akira Mitsuhashi, Takafumi Shiohara, Midori Yatabe, Atsuhiro Ichihara, Shuji Sakai
PURPOSE: To assess the effectiveness of image fusion guidance (IF) with pre-procedural computed tomography (CT) with intraprocedural fluoroscopy for adrenal venous sampling (AVS). MATERIALS AND METHODS: AVS before and after ACTH stimulation including bilateral segmental sampling of effluent tributaries was performed in 62 patients with IF. A 3D volume rendering image, including adrenal glands and veins extracted from previously obtained contrast-enhanced CT images, was manually registered to the real-time X-ray fluoroscopy...
March 14, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29521660/update-in-adrenal-venous-sampling-for-primary-aldosteronism
#12
Gian Paolo Rossi
PURPOSE OF REVIEW: Current guidelines recommend adrenal venous sampling (AVS) to identify the surgically curable causes of hyperaldosteronism. In contrast with this recommendation, AVS remains markedly underutilized in clinical practice, which leads to deny curative adrenalectomy, to many patients with primary aldosteronism. The purpose of this review is to challenge the views that AVS is a technically challenging, invasive and risky procedure, which moreover, is difficult to interpret...
June 2018: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/29467114/adrenal-venous-sampling-the-learning-curve-of-a-single-interventionalist-with-282-consecutive-procedures
#13
Hugo Jakobsson, Katerina Farmaki, Augustinas Sakinis, Olof Ehn, Gudmundur Johannsson, Oskar Ragnarsson
PURPOSE: Primary aldosteronism (PA) is a common cause of secondary hypertension. Adrenal venous sampling (AVS) is the gold standard for assessing laterality of PA, which is of paramount importance to decide adequate treatment. AVS is a technically complicated procedure with success rates ranging between 30% and 96%. The aim of this study was to investigate the success rate of AVS over time, performed by a single interventionalist. METHODS: This was a retrospective study based on consecutive AVS procedures performed by a single operator between September 2005 and June 2016...
February 21, 2018: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/29465715/application-of-strict-criteria-in-adrenal-venous-sampling-increases-the-proportion-of-missed-patients-with-unilateral-disease-who-benefit-from-surgery-for-primary-aldosteronism
#14
Gregory Kline, Alexander Leung, Benny So, Alex Chin, Adrian Harvey, Janice L Pasieka
OBJECTIVES: Adrenal vein sampling (AVS) is intended to confirm unilateral forms of primary aldosteronism, which are amenable to surgical cure. Excessively strict AVS criteria to define lateralization may result in many patients incorrectly categorized as bilateral primary aldosteronism and opportunity for surgical cure missed. METHODS: Retrospective review of an AVS-primary aldosteronism database in which surgical cases are verified by standardized outcomes. Having used 'less strict' AVS criteria for lateralization, we examined the distribution of AVS lateralization indices in our confirmed unilateral primary aldosteronism cases both with and without cosyntropin stimulation...
June 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29464741/accuracy-of-adrenal-computed-tomography-in-predicting-the-unilateral-subtype-in-young-patients-with-hypokalaemia-and-elevation-of-aldosterone-in-primary-aldosteronism
#15
Hironobu Umakoshi, Tatsuki Ogasawara, Yoshiyu Takeda, Isao Kurihara, Hiroshi Itoh, Takuyuki Katabami, Takamasa Ichijo, Norio Wada, Yui Shibayama, Takanobu Yoshimoto, Yoshihiro Ogawa, Junji Kawashima, Masakatsu Sone, Nobuya Inagaki, Katsutoshi Takahashi, Minemori Watanabe, Yuichi Matsuda, Hiroki Kobayashi, Hirotaka Shibata, Kohei Kamemura, Michio Otsuki, Yuichi Fujii, Koichi Yamamto, Atsushi Ogo, Toshihiko Yanase, Shintaro Okamura, Shozo Miyauchi, Tomoko Suzuki, Mika Tsuiki, Mitsuhide Naruse
CONTEXT: The current Endocrine Society Guideline suggests that patients aged <35 years with marked primary aldosteronism (PA) and unilateral adrenal lesions on adrenal computed tomography (CT) scan may not need adrenal vein sampling (AVS) before proceeding to unilateral adrenalectomy. This suggestion is, however, based on the data from only one report in the literature. OBJECTIVE: We sought to determine the accuracy of CT findings in young PA patients who had unilateral adrenal disease on CT with hypokalaemia and elevation of aldosterone...
May 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29453922/a-short-review-of-primary-aldosteronism-in-a-question-and-answer-fashion
#16
Frederick-Anthony Farrugia, Nicolaos Zavras, Georgios Martikos, Panagiotis Tzanetis, Anestis Charalampopoulos, Evangelos P Misiakos, Dimitrios Sotiropoulos, Nikolaos Koliakos
OBJECTIVES: The aim of this study was to present up to date information concerning the diagnosis and treatment of primary aldosteronism (PA). PA is the most common cause of endocrine hypertension. It has been reported up to 24% of selective referred hypertensive patients. METHODS: We did a search in Pub-Med and Google Scholar using the terms: PA, hyperaldosteronism, idiopathic adrenal hyperplasia, diagnosis of PA, mineralocorticoid receptor antagonists, adrenalectomy, and surgery...
January 1, 2018: Endocrine Regulations
https://www.readbyqxmd.com/read/29422627/the-influence-of-the-peripheral-cortisol-fluctuation-on-the-success-rate-of-adrenal-venous-sampling
#17
Chin-Chen Chang, Bo-Ching Lee, Kao-Lang Liu, Yeun-Chung Chang, Vin-Cent Wu, Kuo-How Huang, Tung-Hsin Wu
In this retrospective study, we aimed to estimate the influence of fluctuating peripheral plasma cortisol concentration (PCC) on the success rate of non-stimulated adrenal venous sampling (AVS) and to demonstrate its fluctuating pattern. Overall, 107 consecutive patients with primary aldosteronism undergoing AVS between July 2015-January 2017 were included. The peripheral vein was sampled at 4 separate time points during the procedure: after femoral puncture, during left adrenal sampling, during right adrenal sampling, and before procedural ending...
February 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29409357/macrolides-for-kcnj5-mutated-aldosterone-producing-adenoma-mapa-design-of-a-study-for-personalized-diagnosis-of-primary-aldosteronism
#18
Giuseppe Maiolino, Giulio Ceolotto, Michele Battistel, Giulio Barbiero, Maurizio Cesari, Laurence Amar, Brasilina Caroccia, Roberto Padrini, Michel Azizi, Gian Paolo Rossi
PURPOSE: Aldosterone-producing adenoma (APA) is the main curable cause of endocrine hypertension cause of primary aldosteronism (PA) and it is in up to 66% of all cases investigated with adrenal vein sampling (AVS). Mutations in the KCNJ5 potassium channel involve up to 70% of APA and cause the most florid PA phenotypes. The recent finding that macrolide antibiotics specifically inhibit in vitro the altered function of mutated KCNJ5 channels has opened new horizons for the diagnosis and treatment of APA with KCNJ5 mutations in that it can allow identification and target treatment of PA patients harbouring a mutated APA...
February 6, 2018: Blood Pressure
https://www.readbyqxmd.com/read/29388434/improved-technical-success-and-radiation-safety-of-adrenal-vein-sampling-using-rapid-semi-quantitative-point-of-care-cortisol-measurement
#19
Michael M Page, Mario Taranto, Duncan Ramsay, Greg van Schie, Paul Glendenning, Melissa J Gillett, Samuel D Vasikaran
Objective Primary aldosteronism is a curable cause of hypertension which can be treated surgically or medically depending on the findings of adrenal vein sampling studies. Adrenal vein sampling studies are technically demanding with a high failure rate in many centres. The use of intraprocedural cortisol measurement could improve the success rates of adrenal vein sampling but may be impracticable due to cost and effects on procedural duration. Design Retrospective review of the results of adrenal vein sampling procedures since commencement of point-of-care cortisol measurement using a novel single-use semi-quantitative measuring device for cortisol, the adrenal vein sampling Accuracy Kit...
January 1, 2018: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/29378066/free-and-bound-cortisol-in-plasma-and-saliva-during-acth-challenge-in-dairy-cows-and-horses
#20
Ann-Catherine Schwinn, Fay J Sauer, Vincenz Gerber, Rupert M Bruckmaier, Josef J Gross
Cortisol levels reflect hypothalamic-pituitary-adrenocortical (HPA) axis activity. While most plasma cortisol is supposed to be bound to the soluble corticosteroid-binding globulin (CBG), only free cortisol (FC) actively regulates metabolic and immunological processes. We aimed to establish a multispecies suitable method to assess FC in cows and horses which in combination with total cortisol (TC) allows interpreting proportional changes of cortisol in saliva as well as in blood in response to a standardized HPA axis activation via ACTH...
February 15, 2018: Journal of Animal Science
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